Wakefield’s harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction and a value component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that dysfunctions (...) need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction’s harmfulness is best understood in dispositional terms. (shrink)

In ‘Rethinking Disease’, Powell and Scarffe1 propose what in effect is a modification of Jerome Wakefield’s2 3 harmful dysfunction analysis of medical disorder. The HDA maintains that ‘disorder’ is a hybrid factual and value concept requiring that a biological dysfunction, understood as a failure of some feature to perform a naturally selected function, causes harm to the individual as evaluated by social values. Powell and Scarffe accept both the HDA’s evolutionary biological function component and its incorporation of a value (...) component. Their proposed ‘new twist’ is to revise the value component: ‘Our proposed definition of disease is as follows: a biomedical state is a disease only if it implicates a biological dysfunction that is, or would be, properly disvalued’. So, they propose that a disorder is a ‘properly disvalued dysfunction’ rather than a ‘harmful dysfunction’, an approach they term ‘thickly normative’ in contrast to the thin normative approach of the HDA. There has been a surge of interest recently in better understanding the ‘harm’ component of the HDA. Powell and Scarffe’s analysis is a helpful contribution to this discussion. We focus here exclusively on their proposal regarding the analysis of the concept of disorder and ignore many important related issues that the authors address, ranging from prioritising resource allocation between disorders and non-disorders to whether the concept of disorder should be replaced by a generic welfarist concept. The resolution of these additional issues depends on first understanding ‘disorder’. The authors’ proposed changes to the HDA also deserve evaluation because the HDA, which has been endorsed by leading nosologists,4 plays an influential role in nosological debate across categories of disorder ranging, for example, from sexual paraphilias5 to psychopathy.6 A basic problem is that Powell and Scarffe misinterpret …. (shrink)

Argues that educators should help students piece together authentic narratives about themselves and about society, and not to focus so much on teaching students to process information.

Living in the Borderland addresses the evolution of Western consciousness and describes the emergence of the "Borderland," a spectrum of reality that is beyond the rational yet is palpable to an increasing number of individuals. Building on Jungian theory, Jerome Bernstein argues that a greater openness to transrational reality experienced by Borderland personalities allows new possibilities for understanding and healing confounding clinical and developmental enigmas." "Living in the Borderland challenges the standard clinical model, which views normality as an absence (...) of pathology and which equates normality with the rational. Jerome S. Bernstein describes how psychotherapy itself often contributes to the alienation of Borderland personalities by misperceiving the difference between the pathological and the sacred. The case studies included illustrate the potential this has for causing serious psychic and emotional damage to the patient." "This challenge to the orthodoxies and complacencies of western medicine's concept of pathology will interest Jungian Analysts, Psychotherapists, Psychiatrists and other physicians, as well as educators of children. (shrink)

Until now, however, little has been devoted to the results of various abortion policy changes. Legge examines the effects of abortion policy changes on maternal and infant health in the United States, Great Britain, and Eastern Europe.

However one conceives of the relation between a sign and its significate, referring is a communicative act in which a speaker must intentionally direct the attention of an interlocutor to some object, event, or state of affairs that the speaker has in mind. This article examines the ontogenesis and phylogenesis of acts of referring, with special concern for the possible nature of sign-significate relationships. Findings from developments psychology indicate that a group of abilities and skills underlie the ability to refer. (...) Infants follow the gaze of others to objects of attention, and enjoy joint attention with others. Interactions with caregivers in routines well known to the child enable her to achieve joint attention with the adult on a particular ingredient in the routine. In this way, the ability to refer develops from certain "language games ", interactions that combine goal-seeking and joint attention. (shrink)

At least five sets of ethical standards influence business people's decisions: general cultural, company, personal, situational, and industry standards. Each has an official or espoused form encoded in written documents such as policy statements and codes of ethics and an unofficial form that develops as people use the espoused standards. (We call these unofficial standards values in action.) To determine whether the high-technology industry deserves its reputation for moral laxness, a pilot questionnaire was designed. It asked employees to rate the (...) acceptability in the workplace of ethical behaviors relating to safety, third parties, and cheating the company. The findings show that employees in high-and low-technology industries uphold espoused values of safety. Relations with third parties are influenced by the existence of company codes of ethics, especially in small companies. Actions involving cheating the company need to be investigated further. (shrink)

Decades of research have investigated the complex role of source credibility in attitude persuasion. Current theories of persuasion predict that when messages are thoughtfully scrutinized, argument strength will tend to have a greater effect on attitudes than source credibility. Source credibility can affect highly elaborated attitudes, however, when individuals evaluate material that elicits low attitude extremity. A recently proposed model called the guru effect predicts that source credibility can also cause attitudinal change by biasing the interpretation of pragmatically ambiguous material. (...) The present studies integrate models of explanatory pragmatics and persuasion in order to empirically assess these hypotheses. Experiment 1 found that text difficulty and attitude neutrality reflect independent persuasion variables. Experiment 2 found that higher source credibility causes more favorable attitudes toward messages eliciting low attitude extremity. Text difficulty was not found to have a significant effect on attitudes. These results confirm the predictions of prior social cognition research but no do not support the guru effect model. The implications of these studies for pragmatics and persuasion research as well as the value of interdisciplinary research between these fields are discussed. (shrink)

In “Genetic Privacy, Disease Prevention, and the Principle of Rescue,” Madison Kilbride argues that patients have a duty to warn biological family members about clinically actionable adverse genetic findings. The duty does not stem from the special obligations that we may have to family members, she argues, but rather follows from the principle of rescue, which she understands as the idea that one ought to prevent, reduce, or mitigate the risk of harm to another person when the expected harm is (...) serious and the cost or risk to oneself is sufficiently moderate. We doubt, however, whether the principle of rescue can ground a duty to warn in the cases Kilbride envisages, and we suggest that Kilbride may have underappreciated the role that special obligations could play in generating a duty to warn family members. (shrink)